Advanced Practice Registered Nurse (APRN) Services
Eligible Providers
Enrolled APRNs or PAs will receive 90 percent of the physician rate and should not use modifier U7 when billing PrimeWest Health. The services of APRNs or PAs who choose not to enroll will be paid as physician extenders through the supervising physician at 65 percent of the physician rate and will require modifier U7 when billing PrimeWest Health. Registered nurse certified (RN, C) are not eligible to enroll.
Covered Services
Services performed by APRNs are covered if the services are a covered benefit through PrimeWest Health and the services are within the scope of practice for an APRN as described in MN Stat. secs. 148.171 – 148.285.
Billing
Bill for APRN services using HCPCS/CPT codes, and follow PrimeWest Health requirements for covered physician and professional services.
- Enrolled APRNs: enter your individual NPI as the billing provider.
- Enrolled employers of APRNs: enter the individual NPI of the APRN as the rendering provider
- Non-enrolled APRNs: list the supervising physician NPI as the rendering provider; use modifier U7 to amend the procedure code.
